A community cancer clinic, through cooperation with its parent health care system, developed a lung cancer multidisciplinary clinic (MDC) to enhance patient care and prevent outmigration to competing health care systems. The local medical and radiation oncologists collaborated with a thoracic surgeon from the tertiary care hospital in establishing the lung MDC. All the participating physicians are employed by the health care system. A cancer care coordinator assured that all necessary tests were obtained and available to the physicians at least 1 day before the clinic. The multidisciplinary team also included a pulmonologist and met every third week. Other sub-specialists were involved as necessary. Final treatment recommendations using National Comprehensive Cancer Network guidelines were made for each patient at the MDC visit. This clinic, once established, resulted in significant improvements in the quality of care, patient satisfaction and retention of patients. Time from diagnosis to initiation of treatment was reduced to a mean of 18 days from a mean of 24 days. The community cancer clinic had an increase in lung cancer patient care by 28% and a 9.1% increase in gross revenue. The tertiary care hospital benefited by providing all patients with definitive surgery, including minimally invasive surgery. The tertiary hospital thoracic surgeon had a 75% increase in referrals from the lung MDC geographic area over the previous year. This collaboration in the development of MDCs demonstrates how patients, caregivers, and the health care system benefit from MDCs.

Purpose of review: To review the role of pre-biopsy multi-parametric MRI in biopsy-naïve men for the detection of clinically significant prostate cancer.Recent findings: Recent Level 1 evidence shows that multi-parametric MRI has high sensitivity and negative predictive value for the detection of clinically significant prostate cancer in biopsy-naïve men. Concurrent developments include important work in the standardization of MRI-reporting. The low specificity and positive predictive value of MRI means that biopsy is still necessary following MRI.MRI-targeted prostate biopsy has emerged as an alternative diagnostic test to transrectal ultrasound guided prostate biopsy, though its exact role in biopsy naïve men and the optimal technique remain to be defined. Summary:There is the potential for MRI to be used as a triage test to allow a proportion of men to avoid biopsy and remain on PSA surveillance. MRI-suspicious areas can be sampled more intensively using MRI-targeted biopsy that can be carried out in a variety of ways. Future work should focus on the cost-effectiveness of introducing a pre-biopsy MRI pathway in biopsy naïve men and addressing the training needs for such a change.

Urachal remnant diseases are very uncommon pathologies which are mostly benign. Rarely they can progress to a very aggressive form of Urachal cancer. The rarity of this condition has precluded large studies to help guide the diagnostic and therapeutic management of these potentially malignant lesions. In this case, a urachal cyst was discovered and conservative management was employed after a biopsy proved the lesion was benign. Unfortunately this patient represented several years later with a locally advanced urachal cancer. To date, this is the first clearly documented case of malignant transformation. The available literature surrounding these urachal cysts and cancers will be reviewed to determine if anything could have been done differently in this case and in the future should a similar case present.

Background: Urology, traditionally a maledominated specialty, keeping pace with the quickly changing gender landscape, has been characterized by waves of feminization. This study aims to understand the perspectives of women urologists on the obstacles to their career development, and the impact of such hurdles on their professional roles in urological education, practice, and leadership. Methods: 119 female urology residents/consultants were surveyed via a webinar-based platform, covering relevant questions on domains of Academia, Mentorship, Leadership, Parenting, and Charity. Statistical analysis was done using frequency distribution based on the responses. Results: 46.8% of the respondents felt that there is an under-representation of women in academia. ‘Having a good mentor’ was the most important factor for a novice to succeed in academia (68%). The most important trait in becoming a good leader was ‘good communication skills’ (35%), followed by ‘visionary’ (20%). The greatest challenge faced by leaders in the medical field was considered as ‘time management’ (31.9%). Only 21.2% of the participants felt difficulty in having a work-personal life balance, whereas 63.8% of them found it difficult only ‘sometimes’. As a working parent, ‘the guilt that they are not available all the time’ was considered the most difficult aspect (59.5%), and ‘more flexible schedule’ was needed to make their lives as a working parent easier (46.8%). 34% of the respondents were affiliated with some charitable organizations. The biggest drive to do charity was their satisfaction with a noble cause (72.3%). Conclusions: Need for increased encouragement and recruitment of females into urology, and to support and nurture them in their career aspirations.

We live in a professional environment in which the role of the dental surgeon is changing more rapidly than perhaps ever before. The concept of team working towards more efficient and focused delivery of care to our patients is one of the major developments, both within the practice environment through professionals complementary to dentistry, and indeed through medical and surgical colleagues in dealing with some of the wider aspects of holistic healthcare.